Recovery and adaptation Dr Steve Ingham Head of Physiology, English Institute of Sport, UK
250 staff
Centres at – – – – – – – –
Loughborough University Sportscity, Manchester, Sheffield, Gateshead, Bisham Abbey, Bath University, Alexander Stadium/Lilleshall, London (Twickenham, Brunel University, Lee Valley) – Milton Keynes
– – – – – – – – –
Medicine Physiotherapy Strength & Conditioning Physiology Performance Analysis Biomechanics Nutrition Psychology Performance Lifestyle Performance Lifestyle
4000 hours of support per week
88% 83% 95%
91%
84% 84%
“Are y you going g g to make me go faster?”
“Just Just tell me if I am talking crap”
“D ’t ruin “Don’t i th the hi high-jump!” hj !”
Training categorisation Training categorisation 9 8 7 6 5 4 3 2 1 0
VO2
Heart Rate 200
LT2
VO2 max
160
Race Pace
120 80
He eart rate (b b/min)
Blood lactate (mM) Oxyygen uptakke (l/min)
Blood Lactate
40 0 14
15
16
17
18
19
20
21
22
23
Running speed (km/hr)
P Proportio n of total training vvolume (% %)
90 80 70 60 50 40 30 20 10 0
Sub‐LT2 Sub LT2
LT2‐VO2max LT2 VO2max
Cycling
70
20
10
Swimming Canoeing
77 60
16.4 30
6.6 10
Athletics hl
50.7
29.6
19.7
Training category
VO2max‐Race VO2max Race Pace + Pace +
What are the ‘stresses’ in running? What are the stresses in running?
*my notes only
Comparison between sports of rowing and athletics
Injury
82
3
Over‐training'
15
4 73 2 0
15-17
Forces through single limb on Forces through single limb on ground contact x body mass
7-9
3-6 3-5 2-4
Source: Dr Paul Brice, Biomechanist, English Institute of Sport
Eccentric load •
•
•
•
Concentric (contraction) and eccentric (lengthening ( g g action) ->Eccentric phase involves fewer muscle fib fibres ffor a given i fforce ->Strain on contractile and structural components of the muscle ->Micro-trauma
The issues in athletics/running The issues in athletics/running • Key observations – ‘Over‐training’ cases are rare g – Problems with injury/tolerance of mechanical loading (soreness) are high loading (soreness) are high – Use of recovery treatments is high – 16/27 are ‘attached’ to recovery treatment / ‘ h d’ – Role of other support disciplines!
Thoughts on adaptation Thoughts on adaptation Some distinctions to be made 1. Training response vs injury 1 2. Maximum adaptation vs maximum t i i lload d training 3. Training vs competition
How do you get fit? How do you get fit? Mechanical (inc neural)/ metabolic stimulus
Train
Hormonal,, immune response inflammation breakdown gene transcription growth
Blood flow/ Eat/Drink Nutrients
Adapt p
No further stress t
Rest
Jean Baptiste Lamark Jean Baptiste First Law: Fi L I every animal In i l which hi h has h not passed d the h limit li i of its development, a more frequent and continuous use of any organ gradually strengthens, strengthens develops and enlarges that organ, and gives it a power proportional to the length of time it has been so used; while the permanent disuse of any organ imperceptibly weakens and deteriorates it, and progressively diminishes its f ti functional l capacity, it until til it finally fi ll disappears“. di “
-v ve
Performance
+ve +
Stress/Adaptation
Time (hours, days)
R Repeated bout effect t d b t ff t
-ve
Performanc P ce
+ve
» Presenting the same stimulus to the body again » Reduced disturbance in homeostasis » BUT will probably result in smaller adaptive response
Time (hours, (hours days)
vs vs.
trained Gene Ex xpression
Gene Ex xpression
untrained
Flueck M. (2010) Myocellular limitations of human performance and their modification through genome‐dependent responses at altitude. Exp Physiol. 95(3):451‐62
Diminishing returns Diminishing returns
Perry et al (2010). Repeated transient mRNA bursts precede increases in transcriptional and mitochondrial proteins during training in human skeletal muscle. J Physiol. 1;588 4795‐810
Strength changes vs stimulus Strength changes vs stimulus 100
*
Performan nce
MVC (N.m)
+ve
90 80 70 60 WARM CON
-ve
50 40
Pre Day 1 Day 2 Day 3 Day 4 Day 7
Time (hours, days)
Time
Ingham et al (2010) Effect of a concentric warm-up exercise on eccentrically induced soreness and loss of function of the elbow flexor muscles. J Sports Sci. 2010 Nov;28(13):1377-82.
Recovery treatments Recovery treatments
Progress? 2002‐5
2012
Perceivved sorenesss (1‐10) Isomettric force (Nm.kg‐1)
C t l Control
CWI
0
24
Ice baths Ice baths
8 6 4 2 0 Pre
1
48
168
35 3.5 3 2.5 2 1.5 1 Pre
24 48 Time (hours)
168
10-15° 10 15° C water 10-15 mins
Bailey et al, 2007 Influence of cold-water immersion on indices of muscle damage following prolonged intermittent shuttle running. J Sports Sci.Sep;25(11):1163-70.
Magnetic Resonance Imaging p –p plantar flexion 12 sets of 5 repetitions T2 relaxation time as marker of intra muscular water Control
Cold water immersion 15 mins at 5 deg
Yanagisawa et al (2003) Evaluations of cooling exercised muscle with MR imaging and 31P MR spectroscopy. Med Sci Sports Exerc. 2003 Sep;35(9):1517-23.
Meta analysis of CWI Meta‐analysis of CWI
CWI has a moderate effect in alleviating soreness from exercise in general
CWI;
CWI is highly effective in alleviating soreness after high intensity exercise
CK efflux CK CK efflux ‐ efflux ‐ reduced Muscle strength –– little effect Muscle strength Muscle power –– helps recovery Muscle power
Soreness
Leeder et al (2011) Cold water immersion and recovery from strenuous exercise: a meta-analysis. Br J Sports Med. 22
“Ice-baths help me to run the day after a hard session” Do workout Recovery therapy h must work
Feel sore
Unable to complete next session
Able to complete next workout
Feel less sore
Do next workout Use recovery therapy
Long term adaptation? g p Pe ercentage e change (%)
16 14
Cooled
†
Control
†
12 10
†
8 6 4 2 0 -2 -4 Perfomance trial
VO2max
VT
Test parameter
Femoral artery diameter
Yamane et al., 2006 Post-exercise leg and forearm flexor muscle cooling in humans attenuates endurance and resistance training effects on muscle performance and on circulatory adaptation. Eur J Appl Physiol. 2006 Mar;96(5):572-80. Epub 2005 Dec 22.
Ibuprofen Maximal over‐the‐counter d dose • (IBU 1200mg.day, ACET (4000mg day) (4000mg.day) • Double‐blind placebo controlled • 10‐14 sets of 10 eccentric reps at 120% of concentric reps at 120% of concentric max of knee extensors
Measured skeletal muscle protein synthesis 24hours i h i 24h after damaging exercise via Fractional Synthesis Rate Synthesis Rate ‘Fractional (FSR).
Blocking COX‐2 pathway, reduces inflammation and soreness. Trappe et al.,m (2002) Effect of ibuprofen and acetaminophen on postexercise muscle protein synthesis. Am J Physiol Endocrinol Metab. 2002 Mar;282(3):E551-6.
Repeated sprint performance pre-post recovery and 3 week gain
10
Control Skinz Cold D25mg D50mg
24h post training relative to pre-training
8
6
b a a a
4
a
a
a
% gain on repeat sprints (mean) a
a
a
2
0
2 -2
-4
-6
Week 1 Week 2 a: p<0.05; b: p<0.1
% gains from 3 Week training block
Week 3
At the end of a short training block cold and D50mg lessened gains
By week 2 only cold and D50mg (x2 p.d p.d)) were Having significant recovery effects Data courtesy of Christian Cook
“Am I just doing more training to get the same effect”
“Ice-baths help me to run the day after a hard session”
Do workout specific to individual needs
Do workout Recovery therapy h must work
Feel sore
Unable to complete next session
Able to complete next workout
Feel less sore
Do next workout Use recovery therapy
Feel less sore
Do next workout
Adjust expectations for training for training following hard sessions
Feel sore
Unable to complet next session
Adjust next session
Periodising recovery treatments Adaptation more important, recovery less important –i.e. mid season/national champs i id / ti l h • • • • • • • •
Active recovery Contrast bathingg Deep water exercise Compression garments Ice baths NSAID Massage Stretching
× × × -
Yes Yes Yes No (may impair adaptation) No (may impair adaptation) No (may impair adaptation) For other reasons For other reasons For other reasons
Recovery more important, adaptation less Recovery more important adaptation less important –i.e. World Champs, later races • • • • • • • •
Active recovery Active recovery Contrast bathing Deep water exercise Compression garments Ice baths NSAID Massage Stretching
× -
Yes es Yes Yes Yes Yes No unless medical No unless medical For other reasons For other reasons
Recovery Plan Finish race
What?
Why
After your transition through media and within 5 mins i
Recovery drink, e.g. REGO 100g with 750 ml of water
Rapid replenishment of muscle fuel stores Enhanced muscle recovery and Enhanced muscle recovery and repair Enhanced hormonal profile and immune function
Sort yyour self out then go g straight for a …
Active recovery walk of 10 y mins
Improved metabolic clearance Enhanced immune response Improved readiness for the next session
OPTIONAL depending upon OPTIONAL depending upon your therapy plan (needs to be consistent with previous competitions)
Massage or treatment Massage or treatment
Depends upon plan Depends upon plan
Then either
Contrast bathing Contrast bathing/showers; 15 mins (3 mins warm; 1 min cold x 5) finish on cold,
Improved metabolic clearance Reduced inflammatory response
OR
Ice bath, 10 mins at 10°C water
Reduced muscle damage Reduced soreness
Before you leave the warm‐ up track…
Compression socks on
Improved blood flow preventing pooling in lower limbs pooling in lower limbs Reduced soreness and damage
If you have time when you get back to your room…
Elevate legs for 20 to 30 mins
Reduced blood pooling Reduced inflammation
Percenttage change (%)
Is it better to warm down or sit down? 120
Blo ood lactatte (% of m max)
100
16 14 12 10 8 6 4 2 0 -2 -4
Control Cooled
Perfomance ti l trial
80
VO2max
VT
Test parameter
Passive
60
Massage Run
40
Bikee 20 0 5
10
15 20 Time post (min)
25
30
Femoral artery t diameter
PGC1 1 α mRNA
8
Pre
30 0 s
VEGF mR RNA / RP2 (A A.U.)
vs
4 mins
120s
3 fold
4 mins
30 0 s
4 mins
30 0 s
30 0 s
Post‐exercise response to interval or all‐out p
Post
6 4 2 0
5
Pre
Post
4 3 2 1 0
Int
Cont
Int
Cont
Gibala, et al (2009). Brief intense interval exercise activates AMPK and p38 MAPK signaling and increases the expression of PGC‐1a in human skeletal muscle. J. Appl. Physiol. 106: 929–934. Taylor et al., (current study ). Interval and all‐out continuous exercise activates PGC1 a and VEGF signaling in trained athletes
Maximum adaptation is the focus not maximum training Physiology of Performance Potential for energy turnover
Minimising energy expenditure in performance Tactical method
Preparedness
Economy
Physical Pacing Fast-start Even pace
Energy expend Drafting Minimal distance covered
Anthropometric
Ergogenic
Optimal body mass Body comp Fat oxidation Carnitine
CHO drink Bicarb/citrate Caffeine PostCHO/BCAA di k drink
High resistance reps High Intensity warm-up Post – 15 min cool down Ice bath
Anaerobic
Aerobic
Lactate Threshold Th h ld Max lactate steady state reps
Mileage Hill reps Mech/S&C Glut/Ham strength Drills Core stability Compression stockings Fat oxidation
VO2max Peripheral uptake Volume/wk CHO intake Central delivery vVo2max V 2 reps Lung fitness Altitude Hb Ferritin stores Blood volume Tissue hydration Immune function
Anaerobic Capacity
Power
20-90s reps 1-2 sessions/wk CHO intake/ protein Bi-carb β-alanine
Plyometrics Explosive starts Sprint mechanics Caffeine Creatine Resistance training Hormonal response BCAA
Athl t P Athlete Profile fil – June J 2002 Mean ± SD Range
June 2002
Economy (ml.kg-1.km.hr-1)
226
LT (km.hr-1)
16
VO2max (ml.kg-1.min-1)
70
speed VO2max (km.hr-1)
19.4
• International International 5 5 years • Commonwealth Commonwealth champion g • Plateauing in physiology and performance • Coach questions focussed on use of recovery f treatments
Training intensity profile: g yp Male 1500m runner Proportion o of total traaining volume (%)
60
Pre Post
50 40 30 20 10 0 <80
80 to 90
90 to 100 100 to 110 110 to 120 120 to 130 % of VO2max
Ingham, S.A., Fudge, B.W. and Pringle, J.S. (2012) The Change In Training Distribution, Physiological Profile And Performance For A Male International 1500m Runner. IJSPP. 7(2):193-5.
15 Perce entage change (% %)
Year 1
Year 2
10
5
0
-5 5
VO2max
vLT
vVO2 max
RE
The change (%) in physiological measures for year 1 and year 2 (mean of Nov, Mar, Sept) compared with Sept T0 and Sept T1, respectively. NB RE, negative change = RE improvement ).
Yr2
Pre-support
Yr 1
Ingham, S.A., Fudge, B.W. and Pringle, J.S. (2012) The Change In Training Distribution, Physiological Profile And Performance For A Male International 1500m Runner. IJSPP. 7(2):193-5.
Figure 3. The change in 1500m performance speed during competitive races prior to physiological support and during year 1 and 2. Ingham, S.A., Fudge, B.W. and Pringle, J.S. (2012) The Change In Training Distribution, Physiological Profile And Performance For A Male International 1500m Runner. IJSPP. 7(2):193-5.
Training intensity profile: g yp Male 1500m runner Proportion o of total traaining volume (%)
60
Pre Post
50 40 30 20 10 0 <80
80 to 90
90 to 100 100 to 110 110 to 120 120 to 130 % of VO2max
Ingham, S.A., Fudge, B.W. and Pringle, J.S. (2012) The Change In Training Distribution, Physiological Profile And Performance For A Male International 1500m Runner. IJSPP. 7(2):193-5.
Overview Overview • Running is different to most other linear energetic sports due to the neuro‐muscular pattern • Injury rate is high, probably due to high eccentric loading • Recovery treatments are popular • Recovery treatments are not encouraged out of Recovery treatments are not encouraged out of competition (this has taken 8 years to change) • Recovery treatments are used in competition Recovery treatments are used in competition • Focus is returning to understanding and intervening with training first before recovery treatment is considered training first before recovery treatment is considered
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Nigel Walker Ken van Someren
Ferguson occlusion g
800
800
600
600
400
400
200
200
0
0 Bout 1 Bout 2 Bout 3 Bout 4
0‐30
30‐60
60‐90 90‐120
Male
25
Female
Proportion of tottal training volum me ((%)
30
20 15 10 5 0 LT LTP Training intensity
Go old med dals won
20
vVO2max
Physiologists at recent Olympics l i
19 11
Golds
15
Linear (Golds) 11 10
8
9
y = 2.56x y 2.56x ‐ 9.2 R² = 0.999
7
5 1
4
Top the medal table = 24 All 302 golds = 122 0 golds = 3.5
0
3
4
5 6 7 8 9 10 11 12 No. of Physiologists at Olympics
I f Infra‐structure and investment di
Training intensity
How do your athletes actually train?
Time (a microcycle)
• Poor association between intensity prescribed and performed (r=0 and performed (r 0.2 2‐0 0.6) 6)
Stewart AM, Hopkins WG. (1997) Swimmers' compliance with training prescription. Med Sci Sports Exerc. 29(10):1389-92. Hewson DJ, Hopkins WG (1996) Specificity of training and its relation to the performance of distance runners. Int J Sports Med. 17(3):199-204.